A very Special Kind of Lucky
My right shoe makes an odd squishing sound every time I take a step, like I've stepped in a particularly deep puddle, and haven't bothered to change shoes or socks just yet. It's very annoying, and it actually echoes in the practically abandoned stairwell. I've gone up and down these stairs five times today and have yet to meet another soul on them. I suppose the fact that they are hidden in the back corner of the building and aren't located near anyplace actually useful might have something to do with it. I only know they exist because I was hopelessly lost on my first day here and found them on accident. I can feel my heart starting to beat faster as I step off onto floor that houses the cardiac ward.
Next time... Elevator.
Seeming winded or flushed when I walk in to a patient's room, regardless of the reason, leaves a bad taste in my mouth, so I decide to take an extra stroll around the floor to let my heart settle down before going in. I take the opportunity to take one last look at my notes about my patient. I don't actually need to know everything that I have written down, half of it doesn't even apply to me, but I like to be thorough.
A woman in her late 80s, in the hospital for heart issues. I'm supposed to assess her for nutritional risk and determine whether or not she's interested in education on a heart healthy diet, and if she is, provide that education. Par for the course.
Real hospitals are nothing like what you see on TV. Rare diseases with names that no one has ever heard are exactly that, rare and unheard of. I have yet to run into anyone with Drug Resistant Bulgarian Heart Parasites (don't Google that, I made it up). On the other hand, congestive heart failure, heart attack, coronary artery disease, those are so common that I'm actually surprised when I see something different.
While the diagnoses are rarely worth writing home about, the individual patients are a different story. I liken walking into a patient's room to sticking my hand into a magician's hat, provided that magician is schizophrenic and has multiple personality disorder. In the span of ten minutes, I've gone from one room where the patient was so happy to see me that they practically jumped up and hugged me, to another room where I was glad that there was nothing nearby for the patient to throw at my head (that actually happened once, they missed).
My hands are still damp with hand sanitizer as I stroll into the room, flashing my trademark lopsided grin and introducing myself. The patient, I'll call her Pam, smiles at me and waves me in. Pam looks pleased to see me, whether it's because actually wants to see me or she's just happy to have a visitor, I don't know, but she turns the volume down on The Price is Right, a good sign.
"Hey Pam," I say, rubbing my hands together to get rid of the last of the hand sanitizer, "My name is Ryan, I'm a dietetic intern, I'm here to see how you're doing and to have a chat with you about a heart healthy diet. How's that sound?"
"Oh, I suppose that sounds alright," Pam replies warmly.
"Great," I say.
I go through a pretty standard battery of questions with her. How is your appetite? Is that different from normal? Do you have any trouble chewing or swallowing? Have you had any nausea, vomiting, etc. lately? Have you lost any weight recently? They seem like fairly innocuous questions, but what they actually do is let me know if I need to take a closer look at Pam. If she had been losing weight for the past month or two without trying to, then I'd know that I need to find out why.
Pam, however, is just fine. No nutritional risk, so now I move on to the part that causes a lot of people's eyes to glaze over.
"Has anyone ever talked to you about a heart healthy diet before?" I ask, moving from the foot of her bed over to the side.
"No." Pam shakes her head.
"Well, is that something that you think you'd be interested in?"
"I'm old!" she blurts.
I've gotten a lot of replies to that question before, but Pam's is a new one. For some reason it strikes me as funny, and I have to grit my teeth to keep from laughing. The only response I can give her for a moment is a muffled, "mmmhhmm."
Keep it together.
Pam must realize that I'm not sure of where she's going with that statement because she leans back in her bed and takes a deep breath. She looks me straight in the eye and says in the most wonderfully serious way, "I'm 87 years old, and I would very much like to know what it is like to be 97 years old. So yes, Ryan, I do think that I'm interested."
"Well, that's great to hear!" I reply, "Let's start with the basics."
Pam listens intently as I go through the general guidelines of a heart healthy diet: low fat, low cholesterol, low sodium. She even asks me a few questions. It takes a few minutes, but we get around to Pam's diet and the things she could do to make it healthier. At one point, she even decides to mess with me, asking if it's ok for her to continue to have her favorite Sunday treat, deep fried butter sticks (joking or not, I swear I thought my lunch was about to make a reappearance when I thought about that for a second too long).
Pam's candor surprises me. She comes right out and answers any questions I ask her, and even asks many of her own. I never have to prod her to get more information about something or try to drag an answer out of her, she offers them easily. I go through my whole education with her and even walk her through the booklet I have for her.
When I'm done I say, "Well, that's all I had for you, and it sounds to me like you've got it. Do you have any last minute questions for me?"
Pam shakes her head, "Nope. I think I'm good."
"Alright," I say, smiling, "Well if you think of any, just tell your nurse to call me back up here, I'm happy to answer any questions you might have. You have a good day and I hope you get to go home soon."
I walk out of the room with a slight limp, somehow my foot fell asleep. As I round the corner of the nurse's station, I meet my preceptor's eye.
"Everything ok in there?" she asks.
"Yeah. Why?" I ask, bewildered.
"You were in there for 45 minutes," she says, shaking her head, "I was worried I was going to have to rescue you."
I chuckle. "From what?" I jam my thumb over my shoulder. "A little old lady? She's feisty but I think I could take her."
She laughs. "Good to know," she says, "Now come on, we have paperwork to do"
I take one last glance into Pam's room. She's watching the showcase showdown intently. It's an odd feeling, knowing that you're fond of someone, and because of that, you hope you never see them again. If I'm a very special kind of lucky, Pam will remember what I told her tomorrow, and it will help her find out what it's like to be 97.
I never want to see Pam again.
I take off down the hallway, chasing after my preceptor. I wince as my right shoe makes that weird squishing sound again.
I need new shoes.